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I have corresponded with the Secretary of State for Health several times concerning both the earlier consultation and on the need for full involvement in the design of the proposed value based pricing initiative. I have received assurances that the UK Government and the devolved administrations will continue to work closely together in developing a value based pricing approach. Officials have also been involved in UK-wide discussions concerning the value based pricing of medicines.

In its response to the Scottish Parliament Public Petitions Committee in relation to PE1108 regarding the availability on the NHS of cancer treatment drugs, the Scottish Government advised that its focus was to improve access to all newly licensed medicines and not just those to treat cancer. On that basis, no assessment was made of the use of the quality adjusted life year (QALY) health economics tool specifically for small cohorts of poor prognosis patients.

Instead the Scottish Government advised the Committee that the use of QALYs is currently the accepted method in health economics used by both the Scottish Medicines Consortium (SMC) and the National Institute for Health and Clinical Excellence (NICE) to compare between very different medicines and patient groups.

It also clarified that QALYs provide the basis for discussion about individual medicines by the SMC, the QALY alone does not determine the decision.

Guidance to further strengthen the safe and effective use of new medicines across the NHS in Scotland was published on 13 February 2012. This provides NHS boards with specific guidance on local NHS board consideration of medicines which have been accepted by the Scottish Medicines Consortium (SMC), including timescales for (i) reaching formulary decisions and (ii) publishing formulary decisions.

The guidance also clarifies that NHS boards are expected to maintain an overview of the effectiveness of their local arrangements for the introduction of new medicines, including NHS board formulary arrangements.

There are no plans to publish additional guidance for NHS boards on formulary arrangements.

Information on the number of patients who have been given access to cancer medicines that were approved by the Scottish Medicines Consortium under a patient access scheme since 2011 broken down by (a) NHS board and (b) medicine is not held centrally.

Information on SMC advice for medicines accepted with a patient access scheme is available on the SMC website via the following link:

http://www.scottishmedicines.org.uk/Submission_Process/Submission_Guidance_and_Templates_for_Industry/Patient-Access-Schemes.

The Sexual Health and Blood Borne Virus Framework is outcomes focussed. It does not seek to mandate how NHS boards and others should deliver outcomes, and does not set expectations on staffing levels within NHS boards. The framework encourages local needs-assessments to be undertaken to establish what resources are required to deliver on framework outcomes. Staffing levels are therefore entirely a matter for NHS boards. We are not aware of any staffing issues that will compromise delivery of the framework.

The government undertakes annual local area visits to monitor progress of the framework outcomes. These visits will involve detailed discussion on issues of concern in each area and this will provide an opportunity for any staffing issues to be raised. These visits are commencing this month.

The Sexual Health and Blood Borne Virus Framework is outcomes focussed. It does not seek to mandate how NHS boards and others should deliver outcomes, and does not set expectations on staffing levels within NHS boards. The framework encourages local needs-assessments to be undertaken to establish what resources are required to deliver on framework outcomes. Staffing levels are therefore entirely a matter for NHS boards. We are not aware of any staffing issues that will compromise delivery of the framework.

The government undertakes annual local area visits to monitor progress of the framework outcomes. These visits will involve detailed discussion on issues of concern in each area and this will provide an opportunity for any staffing issues to be raised. These visits are commencing this month.

The chemotherapy electronic prescribing and administration system is one that supports safe prescribing and administration practices for chemotherapy. It does not record the amount spent on cancer medicines.

The most recent meeting via teleconference across the four UK administrations was held in November 2011.

The Draft UK Plan on Rare Diseases was launched for public consultation by the Department of Health on Rare Disease Day, 29 February 2012.

The consultation document and accompanying equality analysis can be found on the Department of Health (England) website at:

http://www.dh.gov.uk/health/category/publications/consultations/.

The National Planning Forum will consider both the updated guidance from the National Institute for Health and Clinical Excellence (NICE), and the health technology assessment (HTA) on TAVI commissioned by the National Institute for Health Research as soon as they are published.

NICE has indicated that it expects the Interventional Procedures Programme (IPP) guidance on TAVI to be published before the end of March 2012.

The National Institute for Health Research has indicated that the HTA has been extended in scope to also examine the cohort of people who are eligible for surgery, but are considered high risk. As a result, the HTA is now expected to be published later this summer.

As indicated in the answer to question S4W-03307 on 2 November 2011, the Scottish Health Technologies Group has robust processes in place for monitoring and reviewing publications relating to TAVI.

In the interim, NHS boards continue to ensure that local arrangements are in place so that people with severe aortic stenosis get access to appropriate clinical treatment. As part of those arrangements, where it is considered clinically appropriate by their doctors, people can get access to TAVI treatment through consideration by an individual case panel.

All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.scottish.parliament.uk/parliamentarybusiness/28877.aspx.

Prescribing of cancer medicines is the responsibility of the clinician in charge of an individuals care. The most appropriate treatment, be it surgery, chemotherapy or radiotherapy (or a combination of these) will be made in consultation with the individual and based on a number of factors, such as, the type of cancer, stage of disease at diagnosis and the benefits and risks of the treatment being offered.

Information on the number of patients accessing cancer medicines in Scotland is not held centrally. Prescribing data available centrally relate to numbers and cost of items dispensed by community pharmacists and dispending doctors. These data sets exclude the direct supply of medicines to patients from hospital and hospital-based clinics. There are no plans to introduce a central prescribing database.